- University of Washington (Seattle, WA)
- …**UW Medicine's Patient Financial Services Department** has an outstanding opportunity for a ** Clinical Appeals and Disputes Nurse .** **WORK SCHEDULE** + ... FTE + 100% Remote + Days **POSITION HIGHLIGHTS** The Clinical Appeals and Disputes Nurse ...cycle **REQUIREMENTS** + Active licensure to practice as a Registered Nurse in Washington State + Bachelor's… more
- Molina Healthcare (WI)
- JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals ... health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
- HCA Healthcare (Nashville, TN)
- …TN, TX, UT, VA). Do you want to join an organization that invests in you as a Clinical Appeals Nurse RN ? At Parallon, you come first. HCA Healthcare has ... make a difference. We are looking for a dedicated Clinical Appeals Nurse RN...trends and process improvements. + Currently licensed as a registered nurse ( RN ) in the… more
- BayCare Health System (Clearwater, FL)
- …Qualifications:** + 2 years of experience with case management and/or clinical appeals or claims. + Registered Nurse **Facility:** BayCare Health System, ... team member be working remotely?** Hybrid Equal Opportunity Employer Veterans/Disabled **Position** Clinical Appeals Nurse - Health Plan **Location**… more
- St. Luke's University Health Network (Allentown, PA)
- …we serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical ... Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. .… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations ( Clinical ) Job Category: Clinical Department: CSC Appeals & ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
- LA Care Health Plan (Los Angeles, CA)
- …the ability to manage multiple training initiatives simultaneously. Licenses/Certifications Required Licensed Registered Nurse ( RN ) - Active, current and ... Lead Customer Solution Center Appeals and Grievances RN Job Category: Clinical Department: CSC ...as assigned. Education Required Associate's Degree in Nursing for Registered Nurses Education Preferred Bachelor's Degree in Nursing for… more
- CVS Health (Columbus, OH)
- …with heart, each and every day. **Position Summary** CVS Aetna is seeking a dedicated ** Appeals Nurse Consultant** to join our remote team. In this role, you ... computer. + Responsible for the review and resolution of clinical appeals . + Reviews documentation and interprets...permitted. **Required Qualifications** + Must have active and unrestricted RN licensure in state of residence. + 3+ years… more
- Nuvance Health (Danbury, CT)
- *Description* *Summary:* The purpose of the Denial Prevention Nurse is to ensure that all patient admissions are appropriately status within the first 12-24 hours ... in preventing payment denials by providing timely and accurate clinical information to all payers, while ensuring compliance with...notice of conversion, etc. * Tracking and trending all appeals and communicating on a daily/regular basis with the… more
- Mount Sinai Health System (New York, NY)
- …(CCM, ACM) or Utilization Management preferred. + 7+ years of experience in clinical acute clinical , utilization management, appeals management or related ... + Ensure timely and appropriate communication with payers for authorization, denials, and appeals . + Collaborate with physicians and clinical teams to ensure… more
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